Exercise, therapy and diet can all improve life during cancer treatment and boost survival. Here’s how
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With so many high-profile people diagnosed with cancer we are confronted with the stark reality the disease can strike any of us at any time. There are also reports certain cancers are increasing among younger people in their 30s and 40s.
On the positive side, medical treatments for cancer are advancing very rapidly. Survival rates are improving greatly and some cancers are now being managed more as long-term chronic diseases rather than illnesses that will rapidly claim a patient’s life.
The mainstays of cancer treatment remain surgery, chemotherapy, radiation therapy, immunotherapy, targeted therapy and hormone therapy. But there are other treatments and strategies – “adjunct” or supportive cancer care – that can have a powerful impact on a patient’s quality of life, survival and experience during cancer treatment.
Keep moving if you can
Physical exercise is now recognised as a medicine. It can be tailored to the patient and their health issues to stimulate the body and build an internal environment where cancer is less likely to flourish. It does this in a number of ways.
Exercise provides a strong stimulus to our immune system, increasing the number of cancer-fighting immune cells in our blood circulation and infusing these into the tumour tissue to identify and kill cancer cells.
Our skeletal muscles (those attached to bone for movement) release signalling molecules called myokines. The larger the muscle mass, the more myokines are released – even when a person is at rest. However, during and immediately after bouts of exercise, a further surge of myokines is secreted into the bloodstream. Myokines attach to immune cells, stimulating them to be better “hunter-killers”. Myokines also signal directly to cancer cells slowing their growth and causing cell death.
Exercise can also greatly reduce the side effects of cancer treatment such as fatigue, muscle and bone loss, and fat gain. And it reduces the risk of developing other chronic diseases such as heart disease and type 2 diabetes. Exercise can maintain or improve quality of life and mental health for patients with cancer.
Emerging research evidence indicates exercise might increase the effectiveness of mainstream treatments such as chemotherapy and radiation therapy. Exercise is certainly essential for preparing the patient for any surgery to increase cardio-respiratory fitness, reduce systemic inflammation, and increase muscle mass, strength and physical function, and then rehabilitating them after surgery.
These mechanisms explain why cancer patients who are physically active have much better survival outcomes with the relative risk of death from cancer reduced by as much as 40–50%.
Mental health helps
The second “tool” which has a major role in cancer management is psycho-oncology. It involves the psychological, social, behavioural and emotional aspects of cancer for not only the patient but also their carers and family. The aim is to maintain or improve quality of life and mental health aspects such as emotional distress, anxiety, depression, sexual health, coping strategies, personal identity and relationships.
Supporting quality of life and happiness is important on their own, but these barometers can also impact a patient’s physical health, response to exercise medicine, resilience to disease and to treatments.
If a patient is highly distressed or anxious, their body can enter a flight or fight response. This creates an internal environment that is actually supportive of cancer progression through hormonal and inflammatory mechanisms. So it’s essential their mental health is supported.
Putting the good things in: diet
A third therapy in the supportive cancer care toolbox is diet. A healthy diet can support the body to fight cancer and help it tolerate and recover from medical or surgical treatments.
Inflammation provides a more fertile environment for cancer cells. If a patient is overweight with excessive fat tissue then a diet to reduce fat which is also anti-inflammatory can be very helpful. This generally means avoiding processed foods and eating predominantly fresh food, locally sourced and mostly plant based.
Muscle loss is a side effect of all cancer treatments. Resistance training exercise can help but people may need protein supplements or diet changes to make sure they get enough protein to build muscle. Older age and cancer treatments may reduce both the intake of protein and compromise absorption so supplementation may be indicated.
Depending on the cancer and treatment, some patients may require highly specialised diet therapy. Some cancers such as pancreatic, stomach, esophageal, and lung cancer can cause rapid and uncontrolled drops in body weight. This is called cachexia and needs careful management.
Other cancers and treatments such as hormone therapy can cause rapid weight gain. This also needs careful monitoring and guidance so that, when a patient is clear of cancer, they are not left with higher risks of other health problems such as cardiovascular disease and metabolic syndrome (a cluster of conditions that boost your risk of heart disease, stroke and type 2 diabetes).
Working as a team
These are three of the most powerful tools in the supportive care toolbox for people with cancer. None of them are “cures” for cancer, alone or together. But they can work in tandem with medical treatments to greatly improve outcomes for patients.
If you or someone you care about has cancer, national and state cancer councils and cancer-specific organisations can provide support.
For exercise medicine support it is best to consult with an accredited exercise physiologist, for diet therapy an accredited practising dietitian and mental health support with a registered psychologist. Some of these services are supported through Medicare on referral from a general practitioner.
For free and confidential cancer support call the Cancer Council on 13 11 20.
Rob Newton, Professor of Exercise Medicine, Edith Cowan University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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From straight to curly, thick to thin: here’s how hormones and chemotherapy can change your hair
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Head hair comes in many colours, shapes and sizes, and hairstyles are often an expression of personal style or cultural identity.
Many different genes determine our hair texture, thickness and colour. But some people’s hair changes around the time of puberty, pregnancy or after chemotherapy.
So, what can cause hair to become curlier, thicker, thinner or grey?
Curly or straight? How hair follicle shape plays a role
Hair is made of keratin, a strong and insoluble protein. Each hair strand grows from its own hair follicle that extends deep into the skin.
Curly hair forms due to asymmetry of both the hair follicle and the keratin in the hair.
Follicles that produce curly hair are asymmetrical and curved and lie at an angle to the surface of the skin. This kinks the hair as it first grows.
The asymmetry of the hair follicle also causes the keratin to bunch up on one side of the hair strand. This pulls parts of the hair strand closer together into a curl, which maintains the curl as the hair continues to grow.
Follicles that are symmetrical, round and perpendicular to the skin surface produce straight hair.
Each hair strand grows from its own hair follicle.
Mosterpiece/ShutterstockLife changes, hair changes
Our hair undergoes repeated cycles throughout life, with different stages of growth and loss.
Each hair follicle contains stem cells, which multiply and grow into a hair strand.
Head hairs spend most of their time in the growth phase, which can last for several years. This is why head hair can grow so long.
Let’s look at the life of a single hair strand. After the growth phase is a transitional phase of about two weeks, where the hair strand stops growing. This is followed by a resting phase where the hair remains in the follicle for a few months before it naturally falls out.
The hair follicle remains in the skin and the stems cells grow a new hair to repeat the cycle.
Each hair on the scalp is replaced every three to five years.
Each hair on the scalp is replaced every three to five years.
Just Life/ShutterstockHormone changes during and after pregnancy alter the usual hair cycle
Many women notice their hair is thicker during pregnancy.
During pregnancy, high levels of oestrogen, progesterone and prolactin prolong the resting phase of the hair cycle. This means the hair stays in the hair follicle for longer, with less hair loss.
A drop in hormones a few months after delivery causes increased hair loss. This is due to all the hairs that remained in the resting phase during pregnancy falling out in a fairly synchronised way.
Hair can change around puberty, pregnancy or after chemotherapy
This is related to the genetics of hair shape, which is an example of incomplete dominance.
Incomplete dominance is when there is a middle version of a trait. For hair, we have curly hair and straight hair genes. But when someone has one curly hair gene and one straight hair gene, they can have wavy hair.
Hormonal changes that occur around puberty and pregnancy can affect the function of genes. This can cause the curly hair gene of someone with wavy hair to become more active. This can change their hair from wavy to curly.
Researchers have identified that activating specific genes can change hair in pigs from straight to curly.
Chemotherapy has very visible effects on hair. Chemotherapy kills rapidly dividing cells, including hair follicles, which causes hair loss. Chemotherapy can also have genetic effects that influence hair follicle shape. This can cause hair to regrow with a different shape for the first few cycles of hair regrowth.
Your hair can change at different stages of your life.
Igor Ivakhno/ShutterstockHormonal changes as we age also affect our hair
Throughout life, thyroid hormones are essential for production of keratin. Low levels of thyroid hormones can cause dry and brittle hair.
Oestrogen and androgens also regulate hair growth and loss, particularly as we age.
Balding in males is due to higher levels of androgens. In particular, high dihydrotestosterone (sometimes shortened to DHT), which is produced in the body from testosterone, has a role in male pattern baldness.
Some women experience female pattern hair loss. This is caused by a combination of genetic factors plus lower levels of oestrogen and higher androgens after menopause. The hair follicles become smaller and smaller until they no longer produce hairs.
Reduced function of the cells that produce melanin (the pigment that gives our hair colour) is what causes greying.
Theresa Larkin, Associate professor of Medical Sciences, University of Wollongong
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Four Thousand Weeks – by Oliver Burkeman
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This is not, strictly speaking, a time management book. It’s more a “contemplating mortality and making things count while still doing the necessaries”.
Burkeman’s premise is that we get around 4,000 weeks of life, on average. If we live to 120, it’s more like 6,200. Unlucky souls may have to do the best they can with 1,000 or so.
The book is thought-provoking; consider:
- how was your last week?
- how will your next week be?
- what if it were your last?
Of course, we cannot necessarily liquidate all our assets and spend next week burning out in style, because then the following week comes. So, what’s the solution?
That’s something Burkeman lays out over the course of the book, with key ideas including passion projects and figuring out what can be safely neglected, but there’s far more there than we could sum up here.
Bottom line: if you ever find yourself struggling to balance what is expected of you with what is of value to you, this book can help you get the most out of your choices.
Click here to check out Four Thousand Weeks, and make yours count!
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Exercise Less, Move More
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Exercise Less, Move More
Today we’re talking about Dr. Rangan Chatterjee. He’s a medical doctor with decades of experience, and he wants us all to proactively stay in good health, rather than waiting for things to go wrong.
Great! What’s his deal?
Dr. Chatterjee advises that we take care of the following four pillars of good health:
- Relaxation
- Food
- Movement
- Sleep
And, they’re not in this order at random. Usually advice starts with diet and exercise, doesn’t it?
But for Dr. Chatterjee, it’s useless to try to tackle diet first if one is stressed-to-death by other things. As for food next, he knows that a good diet will fuel the next steps nicely. Speaking of next steps, a day full of movement is the ideal setup to a good night’s sleep—ready for a relaxing next day.
Relaxation
Here, Dr. Chatterjee advises that we go with what works for us. It could be meditation or yoga… Or it could be having a nice cup of tea while looking out of the window.
What’s most important, he says, is that we should take at least 15 minutes per day as “me time”, not as a reward for when we’ve done our work/chores/etc, but as something integrated into our routine, preferably early in the day.
Food
There are no grand surprises here: Dr. Chatterjee advocates for a majority plant-based diet, whole foods, and importantly, avoiding sugar.
He’s also an advocate of intermittent fasting, but only so far as is comfortable and practicable. Intermittent fasting can give great benefits, but it’s no good if that comes at a cost of making us stressed and suffering!
Movement
This one’s important. Well, they all are, but this one’s particularly characteristic to Dr. Chatterjee’s approach. He wants us to exercise less, and move more.
The reason for this is that strenuous exercise will tend to speed up our metabolism to the point that we will be prompted to eat high calorie quick-energy foods to compensate, and when we do, our body will rush to store that as fat, understanding (incorrectly) that we are in a time of great stress, because why else would we be exerting ourselves that much?
Instead, he advocates for building as much natural movement into our daily routine as possible. Walking more, taking the stairs, doing the gardening/housework.
That said, he does also advise some strength-training on a daily basis—bodyweight exercises like squats and lunges are top of his list.
Sleep
Here, aside from the usual “sleep hygiene” advices (dark cool room, fresh bedding, etc), he also advises we do as he does, and take an hour before bedtime as a purely wind-down time. In gentle lighting, perhaps reading (not on a bright screen!), for example.
Ready to start the next day, relaxed and ready to go.
If you’d like to know more about Dr. Chatterjee’s approach…
You can check out his:
If you don’t know where to start, we recommend the blog! It has a lot of guests there too, including Wim Hof, Gabor Maté, Mindy Pelz, and come to think of it, a lot of other people we’ve also featured ideas from previously!
Enjoy!
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Strength training has a range of benefits for women. Here are 4 ways to get into weights
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Picture a gym ten years ago: the weights room was largely a male-dominated space, with women mostly doing cardio exercise. Fast-forward to today and you’re likely to see women of all ages and backgrounds confidently navigating weights equipment.
This is more than just anecdotal. According to data from the Australian Sports Commission, the number of women participating in weightlifting (either competitively or not) grew nearly five-fold between 2016 and 2022.
Women are discovering what research has long shown: strength training offers benefits beyond sculpted muscles.
John Arano/Unsplash Health benefits
Osteoporosis, a disease in which the bones become weak and brittle, affects more women than men. Strength training increases bone density, a crucial factor for preventing osteoporosis, especially for women negotiating menopause.
Strength training also improves insulin sensitivity, which means your body gets better at using insulin to manage blood sugar levels, reducing the risk of type 2 diabetes. Regular strength training contributes to better heart health too.
There’s a mental health boost as well. Strength training has been linked to reduced symptoms of depression and anxiety.
Strength training can have a variety of health benefits. Ground Picture/Shutterstock Improved confidence and body image
Unlike some forms of exercise where progress can feel elusive, strength training offers clear and tangible measures of success. Each time you add more weight to a bar, you are reminded of your ability to meet your goals and conquer challenges.
This sense of achievement doesn’t just stay in the gym – it can change how women see themselves. A recent study found women who regularly lift weights often feel more empowered to make positive changes in their lives and feel ready to face life’s challenges outside the gym.
Strength training also has the potential to positively impact body image. In a world where women are often judged on appearance, lifting weights can shift the focus to function.
Instead of worrying about the number on the scale or fitting into a certain dress size, women often come to appreciate their bodies for what they can do. “Am I lifting more than I could last month?” and “can I carry all my groceries in a single trip?” may become new measures of physical success.
Strength training can have positive effects on women’s body image. Drazen Zigic/Shutterstock Lifting weights can also be about challenging outdated ideas of how women “should” be. Qualitative research I conducted with colleagues found that, for many women, strength training becomes a powerful form of rebellion against unrealistic beauty standards. As one participant told us:
I wanted something that would allow me to train that just didn’t have anything to do with how I looked.
Society has long told women to be small, quiet and not take up space. But when a woman steps up to a barbell, she’s pushing back against these outdated rules. One woman in our study said:
We don’t have to […] look a certain way, or […] be scared that we can lift heavier weights than some men. Why should we?
This shift in mindset helps women see themselves differently. Instead of worrying about being objects for others to look at, they begin to see their bodies as capable and strong. Another participant explained:
Powerlifting changed my life. It made me see myself, or my body. My body wasn’t my value, it was the vehicle that I was in to execute whatever it was that I was executing in life.
This newfound confidence often spills over into other areas of life. As one woman said:
I love being a strong woman. It’s like going against the grain, and it empowers me. When I’m physically strong, everything in the world seems lighter.
Feeling inspired? Here’s how to get started
1. Take things slow
Begin with bodyweight exercises like squats, lunges and push-ups to build a foundation of strength. Once you’re comfortable, add external weights, but keep them light at first. Focus on mastering compound movements, such as deadlifts, squats and overhead presses. These exercises engage multiple joints and muscle groups simultaneously, making your workouts more efficient.
2. Prioritise proper form
Always prioritise proper form over lifting heavier weights. Poor technique can lead to injuries, so learning the correct way to perform each exercise is crucial. To help with this, consider working with an exercise professional who can provide personalised guidance and ensure you’re performing exercises correctly, at least initially.
Bodyweight exercises, such as lunges, are a good way to get started before lifting weights. antoniodiaz/Shutterstock 3. Consistency is key
Like any fitness regimen, consistency is key. Two to three sessions a week are plenty for most women to see benefits. And don’t be afraid to occupy space in the weights room – remember you belong there just as much as anyone else.
4. Find a community
Finally, join a community. There’s nothing like being surrounded by a group of strong women to inspire and motivate you. Engaging with a supportive community can make your strength-training journey more enjoyable and rewarding, whether it’s an in-person class or an online forum.
Are there any downsides?
Gym memberships can be expensive, especially for specialist weightlifting gyms. Home equipment is an option, but quality barbells and weightlifting equipment can come with a hefty price tag.
Also, for women juggling work and family responsibilities, finding time to get to the gym two to three times per week can be challenging.
If you’re concerned about getting too “bulky”, it’s very difficult for women to bulk up like male bodybuilders without pharmaceutical assistance.
The main risks come from poor technique or trying to lift too much too soon – issues that can be easily avoided with some guidance.
Erin Kelly, Lecturer and PhD Candidate, Discipline of Sport and Exercise Science, University of Canberra
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Semaglutide’s Surprisingly Unexamined Effects
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Semaglutide’s Surprisingly Big Research Gap
GLP-1 receptor agonists like Ozempic, Wegovy, and other semaglutide drugs. are fast becoming a health industry standard go-to tool in the weight loss toolbox. When it comes to recommending that patients lose weight, “Have you considered Ozempic?” is the common refrain.
Sometimes, this may be a mere case of kicking the can down the road with regard to some other treatment that it can be argued (sometimes even truthfully) would go better after some weight loss:
How weight bias in health care can harm patients with obesity: Research
…which we also covered in fewer words in the second-to-last item here:
But GLP-1 agonists work, right?
Yes, albeit there’s a litany of caveats, top of which are usually:
- there are often adverse gastrointestinal side effects
- if you stop taking them, weight regain generally ensues promptly
For more details on these and more, see:
…but now there’s another thing that’s come to light:
The dark side of semaglutide’s weight loss
In academia, “dark” is often used to describe “stuff we don’t have much (or in some cases, any) direct empirical evidence of, but for reasons of surrounding things, we know it’s there”.
Well-known examples include “dark matter” in physics and the Dark Ages in (European) history.
In the case of semaglutide and weight loss, a review by a team of researchers (Drs. Sandra Christenen, Katie Robinson, Sara Thomas, and Dominique Williams) has discovered how little research has been done into a certain aspect of GLP-1 agonist’s weight loss effects, namely…
Dietary changes!
There’s been a lot of popular talk about “people taking semaglutide eat less”, but it’s mostly anecdotal and/or presumed based on parts of the mechanism of action (increasing insulin production, reducing glucagon secretions, modulating dietary cravings).
Where studies have looked at dietary changes, it’s almost exclusively been a matter of looking at caloric intake (which has been found to be a 16–39% reduction), and observations-in-passing that patients reported reduction in cravings for fatty and sweet foods.
This reduction in caloric intake, by the way, is not significantly different to the reduction brought about by counselling alone (head-to-head studies have been done; these are also discussed in the research review).
However! It gets worse. Very few studies of good quality have been done, even fewer (two studies) actually had a registered dietitian nutritionist on the team, and only one of them used the “gold standard” of nutritional research, the 24-hour dietary recall test. Which, in case you’re curious, you can read about what that is here:
Dietary Assessment Methods: What Is A 24-Hour Recall?
Of the four studies that actually looked at the macros (unlike most studies), they found that on average, protein intake decreased by 17.1%. Which is a big deal!
It’s an especially big deal, because while protein’s obviously important for everyone, it’s especially important for anyone trying to lose weight, because muscle mass is a major factor in metabolic base rate—which in turn is much important for fat loss/maintenance than exercise, when it comes to how many calories we burn by simply existing.
A reasonable hypothesis, therefore, is that one of the numerous reasons people who quit GLP-1 agonists immediately put fat back on, is because they probably lost muscle mass in amongst their weight loss, meaning that their metabolic base rate will have decreased, meaning that they end up more disposed to put on fat than before.
And, that’s just a hypothesis and it’s a hypothesis based on very few studies, so it’s not something to necessarily take as any kind of definitive proof of anything, but it to say—as the researchers of this review do loudly say—more research needs to be done into this, because this has been a major gap in research so far!
Any other bad news?
While we’re talking research gaps, guess how many studies looked into micronutrient intake changes in people taking GLP-1 agonists?
If you guessed zero, you guessed correctly.
You can find the paper itself here:
What’s the main take-away here?
On a broad, scoping level: we need more research!
On a “what this means for individuals who want to lose weight” level: maybe we should be more wary of this still relatively new (less than 10 years old) “wonder drug”. And for most of those 10 years it’s only been for diabetics, with weight loss use really being in just the past few years (2021 onwards).
In other words: not necessarily any need to panic, but caution is probably not a bad idea, and natural weight loss methods remain very reasonable options for most people.
See also: How To Lose Weight (Healthily!)
Take care!
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The Green Roasting Tin – by Rukmini Iyer
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You may be wondering: “do I really need a book to tell me to put some vegetables in a roasting tin and roast them?” and maybe not, but the book offers a lot more than that.
Indeed, the author notes “this book was slightly in danger of becoming the gratin and tart book, because I love both”, but don’t worry, most of the recipes are—as you might expect—very healthy.
As for formatting: the 75 recipes are divided first into vegan or vegetarian, and then into quick/medium/slow, in terms of how long they take.
However, even the “slow” recipes don’t actually take more effort, just, more time in the oven.
One of the greatest strengths of this book is that not only does it offer a wide selection of wholesome mains, but also, if you’re putting on a big spread, these can easily double up as high-class low-effort sides.
Bottom line: if you’d like to eat more vegetables in 2024 but want to make it delicious and with little effort, put this book on your Christmas list!
Click here to check out The Green Roasting Tin, and level-up yours!
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